In 2020, I began to cure a patient with severe bone loss and dental mobility due to advanced periodontitis, especially in the anterior area of the lower jaw. After five years of meticulous periodontal maintenance, I noticed an unexpected and remarkable change when comparing the patient’s radiographs: his bone seemed to be slightly regenerative and the mobility was gone. The only significant change in its medical history has been the start of systematic statins over the last two years.
Curious about this correlation, I began to consider research studies and surprised to discover that statins have a majority, such as reducing inflammation and enhancing bone regeneration. This article analyzes the current elements on the effects of degraded statins after escalating and rooting and systematic use of statin on unprocessed periodontitis.
Import
Hyperlipidemia is defined as a condition characterized by elevated levels of lipid (fats) in the blood, which can increase the risk of cardiovascular disease.1 The lipid that plays a key role in this condition is cholesterol. It is a waxy, oily substance present in every cell of the body and is vital to the production of hormones, vitamin D and bile acids that help digest fat. It is found in the bloodstream in two primary forms: low density lipoprotein (LDL), commonly known as bad cholesterol, which can contribute to plaque accumulation in the arteries and high density lipoprotein (HDL), which is referred to as good cholesterol.2
The most common medicines used to treat hyperlipidemia are statins. The mechanism of action of statins is to inhibit HMG-COA coenzyme to lower blood cholesterol levels. Statins are also known to have a major effect on oral health. These effects are anti -inflammatory, immunomodulatory, antioxidant and bone regenerative properties.
On the other hand, periodontitis is a chronic infectious disease that affects the supporting dental tissues caused by pathogens that accumulate in the plate. It is driven by both germs and host response, resulting in loss of adhesion and cellular bone. As there is a correlation between periodontitis and cardiovascular health, the majority effects of statins could provide benefits to both situations.3
When it comes to periodontitis, antimicrobial agents are used to reduce the number of harmful organisms and to change their ability to cause illness. US Dental Union Practice Guidelines (ADA) constitute local controlled release factors as a complementary treatment in mechanical release, such as monoocline microspheres (Arestin), Doxycylline Gel (Atridox) and Chip Chip Chip. Systematic supply of antimicrobials can reach a wider range of bacteria, but according to ADA, there is a small benefit for the use of systemic antibiotics to treat periodontal disease and are not recommended due to the highest incidence of adverse effects. They should be considered only in cases of aggressive periodontitis.4 The new study introduces statins as an alternative benefit for the treatment of periodontitis in the same way that localized antimicrobial agents have been used.
Locked Delivery Statins in Periodontal
A systematic review and meta-analysis report evaluated the clinical and radiographic effects of degraded statins after escalating and designing roots in patients with periodontitis, including 119 articles and 18 randomized testing tests with 1,171 participants. People were grouped in systematically healthy patients, smokers and diabetic patients. The parameters included Sulcus bleeding indicator, depth of periodontal pocket (PD), clinical attachment profit (CAL) and radiographic reception defects (IBD). The plaque index (pi) was left out, as it had no significant difference in all groups. Drug administration was given at a gel concentration of 1.2%. The attendance took place in three, six and nine months. Amidst the statins examined, Simvastatin (SMV), atorvastatin (ATV) and Rosuvastatin (RSV) had the most significant results in all groups. All patients tolerated drug well, had no side effects, discomfort or complications.
Results
Thirteen of the 18 studies showed a significant improvement in SBI after using statin compared to placebo groups. In healthy patients, ATV improved all parameters and the RSV resulted in significant higher changes in CAL, PD and IBD, while SMV improved everything except PDs and Cal. Two studies were conducted in smokers for at least 10 years. Both ATV and SMV have shown a significant improvement in all parameters. Two other studies conducted in controlled type 2 diabetic patients showed improvement in all parameters in both SMVs and ATV groups, with results favored by SMV but were not statistically significant.
Four articles compared the results of SMV used in healthy patients, controlled diabetic patients and smokers. Most improvement was observed in healthy patients, although the diabetic group had similar results. The least favorable team to see significant changes was the smokers team.
Comparison of statins and other drugs delivered degraded
To examine the effects of statins on the periodontal, a series of studies compared these drugs with non -lipid drugs such as aaldronate (used to treat and prevent osteoporosis), metformin (used to treat type 2 diabetes) and antimicrobial treatment.
- Alendronate 1% vs. Atorvastatin 1.2%: Both improved periodontal parameters, but ATV 1.2% yielded higher CAL profits, while 1% Alnronic showed higher PD and IBD results.
- Metformin 1% versus Rosuvastatin 1.2%: Both improved all parameters except the radiographic IBD.
- Photodynamic Therapy against Simvastatin 1.2%: SMV has shown better results, though not statistically significant.
Systematic review has identified some restrictions, including the need for more recent randomized test tests, as the latter took place in 2018. In addition, 66% of studies included at risk of bias.3
Systematic effects of statins on periodontal
A systematic review in seven studies was analyzed for the effectiveness of statins in the periodontal. There were three cases of cases and four were a transverse section studies. Each study included at least 70 participants aged 30 years or older, all without co -operation. In some studies, the medicines administered were ATV and/or SMV, while other studies did not clarify. The parameters obtained included Pi, Cal, PD, Urine (GI) and bleeding in the detection (BOP). Bone radiographic density was ruled out. Prices that were improved using statin for at least three months included Cal, PD and BOP. Some studies reported reduced CAL values, reinforced PDs in certain groups and significant BOP reductions in all groups, indicating possible anti -inflammatory effects of prolonged statin use. However, the results vary, with some studies that show no significant differences for certain parameters. In addition, GI and PI values have shown mixed results and none of the studies have evaluated the effects of statins on the tissues of the periphery or cellular loss.
Conclusion
The local tradition of statins after escalating and designing roots have shown advantageous results, while systematic statins showed improvement but no statistical significance. However, the inconsistent findings emphasize the need for more research, especially with regard to the tissues of the periphery and the cellular loss. Such studies could deepen our understanding of how statins help to manage periodontitis, thereby improving the treatment strategies and the results of patients.
Note of the author: This article first appeared in Clinical knowledge Information Bulletin, a publication of the Endeavor Business Media Dental Dental Dental. Read more articles and contribute.
References
- Di Spirito F, Schiavo L, Pilone V, Lanza A, Sbordone L, d’Ambrosio F. Periodontic and regional diseases and systematically administered statins: Systematic review. Dent j (kingdom). 2021; 9 (9): 100. Doi: 10.3390/DJ9090100
- What is cholesterol? American Heart Association. February 16, 2024.
- Greethurst Ar, Galletti C, Lo Giudice R, et al. The use of statins as a complementary treatment for periodontal disease: systemic review and meta-analysis. Dent j (kingdom). 2024; 12 (6): 150. Doi: 10.3390/DJ12060150
- Asadoorian J. antimicrobial agents for controlling periodontal disease. In Bowen D, Pieren J, eds. Theory and practice of dental hygiene, 5th edition. Elsevier? 2020: 403-413.
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